Carlson, John Augustave
Carlson, John Augustave is an individual health care provider with primary practice located at 259 Jonesboro Rd , Mcdonough GA 30253-3769. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Carlson, John Augustave can be contacted via phone (770) 957-8666.Contact Information
Primary practice address
259 Jonesboro Rd
Mcdonough GA 30253-3769
Phone: (770) 957-8666
Fax: (770) 957-0375
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 4944 | Georgia |
Profile Details
| NPI number | 1023091964 |
|---|---|
| LBN Legal business name | Carlson, John Augustave |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Mar 16th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023091964 | NPPES |
| Georgia | Other | P00404946 | RR MEDICARE |
| Georgia | MEDICAID | 678871499B | RR MEDICARE |
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